crossing96/oncoscreening huggingface dataset:
Metastatic renal cell carcinoma to the urinary bladder: a report of 11 cases.	"Metastatic renal cell carcinoma (RCC) to the urinary bladder is rarely seen. Herein, we report the histologic subtypes, immunohistochemical characteristics, and prognosis of 11 patients with metastatic RCC to the urinary bladder. The mean age at the time of diagnosis of metastatic RCC to the bladder was 66 years (range, 58 to 79 y). There were 9 male and 2 female patients. Four patients presented with hematuria, 2 with urinary retention/obstruction, and 1 with bladder calculi. Four patients were asymptomatic and presented for surveillance cystoscopy, wherein they were found to have bladder masses. Nine patients had prior histories of RCC. The remaining 2 patients presented with metastatic clear cell RCC to the bladder and were subsequently found to have renal masses. The average time between nephrectomy and metastasis to the bladder was 20.7 months (range, 0 to 87 mo). Of the 10 patients with radical/partial nephrectomy, 7 cases were clear cell (2 with sarcomatoid features), 2 papillary, and 1 chromophobe with histologic fidelity between the primary and metastasis. Of cases with available data, the primaries' ISUP nucleolar grades were 2 (n=2), 3 (n=4), and 4 for the 2 cases with sarcomatoid features. In 8 cases, the bladder RCC undermined overlying urothelium with extensive urothelial denudation, and in 3 cases the RCC was free floating without attachment to the urothelium. The 1 chromophobe RCC metastasized with pagetoid spread to a preexisting urothelial papilloma. PAX8 immunohistochemistry was used to confirm the diagnosis in 2 cases. Three patients have no evidence of disease (7, 9, and 13 mo). Two are alive with disease after chemotherapy (30, 37 mo). Six patients are dead of disease with multiorgan metastases; 4 are dead after therapy (5, 8, 25, 28 mo), and two died without radiation or chemotherapy at 10 and 71 months. Metastatic RCC to the urinary bladder is uncommon, with most cases clear cell RCC. In some cases, evidence supports ""drop metastases"" as the mechanism of spread and patients have relatively long survival. However, in other cases spread to the bladder is in the setting of metastases to other sites, and these patients tended to die relatively shortly after their bladder metastases."	bladder
The Charlson comorbidity index predicts survival after disease recurrence in patients following radical cystectomy for urothelial carcinoma of the bladder.	OBJECTIVE: To identify prognostic clinical and histopathological parameters, including comorbidity indices at the time of radical cystectomy (RC), for overall survival (OS) after recurrence following RC for urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS: A retrospective multicenter study was carried out in 555 unselected consecutive patients who underwent RC with pelvic lymph node dissection for UCB from 2000 to 2010. A total of 227 patients with recurrence comprised our study group. Cox proportional hazards regression models were calculated with established variables to assess their independent influence on OS after recurrence. RESULTS: The median time from RC to recurrence and the median OS after recurrence was 10.9 and 5.4 months, respectively. Neither the time to recurrence nor the type of recurrence (systematic vs. local) was predictive of the OS. In contrast, age (hazard ratio (HR) 1.53, p = 0.011), lymph node metastasis (HR 1.56, p = 0.007), and positive surgical margins (HR 1.53, p = 0.046) significantly affected the OS after disease recurrence. In addition, the dichotomized Charlson comorbidity index (CCI; dichotomized into >2 vs. 0-2) was the only comorbidity score with an independent prediction of OS (HR 1.41, p = 0.033). We observed a significant gain in the base model's predictive accuracy, i.e. from 68.4 to 70.3% (p < 0.001), after inclusion of the dichotomized CCI. CONCLUSIONS: We present the first outcome study of comorbidity indices used as predictors of OS after disease recurrence in patients undergoing RC for UCB. The CCI at the time of RC had no significant influence on the time to recurrence but represented an independent predictor of OS after disease recurrence.	bladder
MALDI imaging-based identification of prognostically relevant signals in bladder cancer using large-scale tissue microarrays.	OBJECTIVE: Although most patients with urinary bladder cancer present with noninvasive and low-malignant stages of the disease, about 20% eventually develop life-threatening metastatic tumors. This study was designed to evaluate the potential of matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MSI) to identify molecular markers predicting the clinical course of bladder cancer. MATERIALS AND METHODS: We employed MALDI-MSI to a bladder cancer tissue microarray including paraffin-embedded tissue samples from 697 patients with clinical follow-up data to search for prognostically relevant associations. RESULTS: Analysis of our MALDI imaging data revealed 40 signals in the mass spectra (m/z signals) associated with epithelial structures. The presence of numerous m/z signals was statistically related to one or several phenotypical findings including tumor aggressiveness (stage, grade, or nodal status; 30 signals), solid (5 signals) or papillary (3 signals) growth patterns, and increased (6 signals) or decreased (12 signals) cell proliferation, as determined by Ki-67 immunohistochemistry. Two signals were linked with tumor recurrence in noninvasive (pTa category) tumors, of which one was also related to progression from pTa-category to pT1-category disease. The absence of one m/z signal was linked with decreased survival in the subset of 102 muscle-invasive cancers. CONCLUSION: Our data demonstrate the suitability of combining MSI and large-scale tissue microarrays to simultaneously identify and validate clinically useful molecular markers in urinary bladder cancer.	bladder
[Characteristics of lymph node metastasis in patients undergoing radical cystectomy for bladder cancer: a retrospective single-center study of 522 cases].	OBJECTIVE: To investigate the characteristics and related influence factors of lymph node metastases in patients undergoing radical cystectomy and lymph node dissection for bladder cancer. METHODS: The data of 522 patients who underwent radical cystectomy and pelvic lymph node dissection at Department of Urology, Peking University First Hospital from 1998 to 2012, were retrospectively collected, and the lymph node mapping was performed in all the patients to determine the location of metastatic lymph nodes. RESULTS: For the 522 patients with bladder cancer, lymph node metastasis occurred in 99 patients, and the incidence of lymph node metastasis was 19.0%. The incidence at different tumor stages was: 3.7% in T1 (6/164), 10.5% in T2 (17/160), 36.7% in T3(40/107), and 41.9% in T4 (36/86). The most common involved lymph nodes were hypogastric/obturator lymph nodes (77/99, 77.8%) and external iliac lymph nodes (35/99, 35.4%). The mean number of lymph nodes dissected was 11.6 (1-51). The lymph node density (number of lymph nodes involved/number of lymph nodes removed) was 44.1%. The incidence of lymph node metastasis was statistical related to tumor stage (P < 0.01, OR 2.71,95% CI 2.13-3.44) and tumor grade (P < 0.01, OR 3.81,95% CI 1.66-8.74), while age, gender, smoke history, and weight had no statistical significance. CONCLUSION: Lymph node metastasis is the most common metastasis route of bladder cancer. The incidence of lymph node tumor involvement is correlated with increasing tumor stage and tumor grade. The most common involved lymph nodes are hypogastric/obturator lymph nodes and external iliac lymph nodes. Radical cystectomy and bilateral pelvic lymph nodes dissection are of great significance in the treatment of bladder cancer.	bladder
Frailty modeling for clustered competing risks data with missing cause of failure.	Competing risks data often occur within a center in multi-center clinical trials where the event times within a center may be correlated due to unobserved factors across individuals. In this paper, we consider the cause-specific proportional hazards model with a shared frailty to model the association between the event times within a center in the framework of competing risks. We use a hierarchical likelihood approach, which does not require any intractable integration over the frailty terms. In a clinical trial, cause of death information may not be observed for some patients. In such a case, analyses through exclusion of cases with missing cause of death may lead to biased inferences. We propose a hierarchical likelihood approach for fitting the cause-specific proportional hazards model with a shared frailty in the presence of missing cause of failure. We use multiple imputation methods to address missing cause of death information under the assumption of missing at random. Simulation studies show that the proposed procedures perform well, even if the imputation model is misspecified. The proposed methods are illustrated with data from EORTC trial 30791 conducted by European Organization for Research and Treatment of Cancer (EORTC).	bladder
Perivascular epithelioid cell tumour of the bladder.	A 39-year-old woman presented with a long history of pelvic pain and urinary urgency. Prior workup by her primary care doctor had been negative. The patient's gynaecologist ultimately referred her to a urologist following an ultrasound that revealed a possible bladder mass. MRI of the abdomen and pelvis demonstrated a 4 cm soft tissue lesion arising from the bladder. Cystoscopy showed an atypical mass on the anterior bladder wall, and pathological examination of the TURBT (transurethral resection of the bladder tumour) specimen revealed a perivascular epithelioid cell tumour (PEComa) with involvement of the detrusor muscle. The patient underwent a robotically assisted laparoscopic partial cystectomy. Final pathology confirmed a PEComa with negative margins. The patient had an uncomplicated postoperative course and is doing well following surgery. A surveillance cystoscopy at 6 months showed no evidence of recurrence. This case underscores the variability of clinical presentation of PEComas while proposing an appropriate method of surgical management.	bladder
Appraisal of diagnostic ability of UCA1 as a biomarker of carcinoma of the urinary bladder.	Initial diagnosis of carcinoma of the urinary bladder remains to be a challenge. Urine cytology, as an adjunct to cystoscopy, is less sensitive for low-grade tumors. Urothelial cancer associated 1 (UCA1) is a novel non-coding RNA gene, which plays a pivotal role in bladder cancer progression. Our aim is to investigate the significance of urinary UCA1 for the non-invasive diagnosis of transitional cell carcinoma (TCC) of the urinary bladder. We examined UCA1 expression in a bladder cancer cell line (T24) and in urine of 28 healthy individuals, 46 patients of non-malignant disorders, and 117 cases (69 primary and 48 recurrent cases) of histologically proven TCC prior to transurethral resection by using real-time PCR and compared it with voided urinary cytology. UCA1 expression was found in T24 cell line and also found to be significantly higher in the cancer group as compared to the controls (p<0.001). UCA1 messenger RNA (mRNA) expression showed a significant (p<0.05) association with stage and grade (p<0.05). UCA1 showed a sensitivity of 79.49% and a specificity of 79.73% (p<0.001), whereas urine cytology had a sensitivity of 66.67% and a specificity of 95.95% for TCC cases. Higher expression of UCA1 was associated with high grade (G2-G3, sensitivity=84.09%) (p<0.001). UCA1 mRNA expression did not significantly correlate with the patient's age, sex, and smoking habit (p>0.05). UCA1 can be used as a non-invasive diagnostic biomarker for TCC bladder as an adjunct to cytology in the early diagnosis of primary urinary bladder cancer.	bladder
Adjuvant chemotherapy after radical cystectomy for bladder cancer: a comparative study using inverse-probability-of-treatment weighting.	OBJECTIVES: The role of adjuvant chemotherapy (AC) after radical cystectomy for bladder cancer remains unclear. This study evaluated the benefits of cisplatin-based AC plus surgery versus surgery alone in patients with bladder cancer. MATERIALS AND METHODS: The medical records of 746 patients who underwent radical cystectomy for bladder cancer were reviewed. The association between AC and survival was analyzed using Cox regression models. To reduce the impact of treatment selection bias and potential confounding in an observational study, significant differences in patient characteristics were rigorously adjusted using inverse-probability-of-treatment weighting (IPTW). RESULTS: The cohort consisted of 746 patients (664 men and 82 women) of mean age 62.4 years and median follow-up of 64.3 months (range, 1-231.4 months). Of these patients, 176 (23.6%) received AC after cystectomy and 570 (76.4%) underwent cystectomy alone. Patients who received AC were significantly younger (60 vs. 63 years, p = 0.001) and significantly more likely to have high pathologic T stage (p = 0.001), lymph node metastasis (p = 0.001), high grade (p = 0.001), and lymphovascular invasion (p = 0.001) than patients who underwent cystectomy alone. Multivariable analysis showed a cancer-specific survival (CSS) benefit for AC [hazard ratio (HR) 0.56, 95% confidence interval (CI) 0.39-0.80, p = 0.002], as did low pathologic T stage, absence of lymph node metastasis, and absence of lymphovascular invasion. After IPTW adjustment for baseline characteristics, AC remained an independent predictor of CSS (HR 0.83, 95% CI 0.69-0.99, p = 0.043). CONCLUSIONS: Cisplatin-based AC after radical cystectomy had survival benefits in patients with bladder cancer, even after IPTW adjustment for confounding variables.	bladder
Treatment of bone metastases in urologic malignancies.	The skeletal system is the most common site of metastatic cancer spread. Bone metastases are often associated with severe morbidity, pain and functional impairment. Timely diagnosis and proper treatment may decrease morbidity, improve quality of life and in some cases even improve survival. External beam radiotherapy may effectively give pain relief in patients with painful bone metastases. In bone metastases from castration-resistant prostate cancer or urothelial bladder cancer, treatment with zoledronic acid or denosumab may reduce skeletal-related events. In contrast to castration-resistant prostate cancer, in patients with bone metastases from bladder cancer such treatment may even improve survival. On the other hand, the efficacy of these agents is questionable in patients with bone involvement from metastatic renal cell carcinoma or germ cell tumors. When bisphosphonates or denosumab are considered in such cases, the potential benefits of treatment should be critically weighed against the risk of side effects. In germ cell tumors, bone metastases may be cured by cisplatin-based chemotherapy, however, there are only limited data on the specific management of residual disease. Oligometastases may be treated by stereotactic radiotherapy or--especially in patients with renal cell carcinoma--by surgical resection and endoprosthetic replacement. Limited data are available on the management of bone involvement in germ cell tumors. Decisions on the resection or local radiotherapy of residual disease should be individualized considering the overall response and the feasibility and risks of resection.	bladder
Enforced expression of miR-101 enhances cisplatin sensitivity in human bladder cancer cells by modulating the cyclooxygenase-2 pathway.	Alterations in microRNA (miRNA) expression have been shown to be involved in the tumor response to chemotherapy. However, the possible role of miR‑101 in cisplatin sensitivity in human bladder cancer cells remains unclear. In this study, quantitative polymerase chain reaction and western blotting were utilized to determine the expression profiles of miR‑101 and cyclooxygenase‑2 (COX‑2) in human bladder cancer cells. The effect of miR‑101 and small interfering RNA (siRNA) against COX‑2 on cell viability was evaluated using MTT assays, and apoptosis levels were determined using fluorescence‑activated cell sorting analysis of Annexin V/propidium iodide‑stained cells. Luciferase reporter plasmids were constructed to confirm direct targeting. This study found that the expression of miR‑101 was downregulated in the cisplatin‑resistant cell line T24/CDDP as compared with that in the parental line, T24. Furthermore, overexpression of miR‑101 significantly increased the anti‑proliferative effects and apoptosis induced by cisplatin, whereas knockdown of miR‑101 significantly decreased the anti‑proliferative effects and apoptosis induced by cisplatin. In addition, downregulation of miR‑101 induced cell survival and cisplatin resistance through the upregulation of COX‑2 expression. Luciferase gene reporter assays confirmed that COX‑2 was a direct target gene of miR‑101. Inhibition of COX‑2 using COX‑2 siRNA abrogated the cisplatin resistance induced by miR‑101 downregulation. These results suggest that miR‑101 may provide a novel mechanism for understanding cisplatin resistance in bladder cancer by modulating the COX‑2 pathway.	bladder
Cardiopulmonary reserve as determined by cardiopulmonary exercise testing correlates with length of stay and predicts complications after radical cystectomy.	OBJECTIVE: To investigate whether poor preoperative cardiopulmonary reserve and comorbid state dictate high-risk status and can predict complications in patients undergoing radical cystectomy (RC). PATIENTS AND METHODS: In all, 105 consecutive patients with transitional cell carcinoma (TCC; stage T1-T3) undergoing robot-assisted (38 patients) or open (67) RC in a single UK centre underwent preoperative cardiopulmonary exercise testing (CPET). Prospective primary outcome variables were all-cause complications and postoperative length of stay (LOS). Binary logistic regression analysis identified potential predictive factor(s) and the predictive accuracy of CPET for all-cause complications was examined using receiver operator characteristic (ROC) curve analysis. Correlations analysis employed Spearman's rank correlation and group comparison, the Mann-Whitney U-test and Fisher's exact test. Any relationships were confirmed using the Mantel-Haenszel common odds ratio estimate, Kaplan-Meier analysis and the chi-squared test. RESULTS: The anaerobic threshold (AT) was negatively (r = -206, P = 0.035), and the ventilatory equivalent for carbon dioxide (VE/VCO₂) positively (r = 0.324, P = 0.001) correlated with complications and LOS. Logistic regression analysis identified low AT (<11 mL/kg/min), high VE/VC0₂ (≥33) and hypertension as significant factors, such that, in their presence patients were 5.55-times more likely to have complications at 90 days postoperatively [P = 0.001, 95% confidence interval (CI) 2.2-13.9]. ROC analysis showed a high significance (area under the curve 0.78, 95% CI 0.69-0.87; P < 0.001). In addition, based on CPET criteria >50% of patients presenting for RC had significant heart failure, whereas preoperatively only very few (2%) had this diagnosis. Analysis using the Mann-Whitney test showed that a VE/VCO₂ ≥33 was the most significant determinant of LOS (P = 0.004). Kaplan-Meier analysis showed that patients in this group had an additional median LOS of 4 days (P = 0.008). Finally, patients with an American Society of Anesthesiologists grade of 3 (ASA 3) and those on long-term β-blocker therapy were found to be at particular risk of myocardial infarction (MI) and death after RC with odds ratios of 4.0 (95% CI 1.05-15.2; P = 0.042) and 6.3 (95% CI 1.60-24.8; P = 0.008). CONCLUSION: Patients with poor cardiopulmonary reserve and hypertension are at higher risk of postoperative complications and have increased LOS after RC. Heart failure is known to be a significant determinant of perioperative death and is significantly under diagnosed in this patient group.	bladder
Whole-lesion diffusion metrics for assessment of bladder cancer aggressiveness.	PURPOSE: To explore associations of whole-lesion histogram diffusion metrics with pathologic findings and subsequent metastatic disease in bladder cancer patients undergoing radical cystectomy. METHODS: Twenty-three bladder cancer patients (21M, 2F; mean 70 ± 11 years) underwent MRI before cystectomy. A volume-of-interest was placed on all slices on the ADC map encompassing each lesion. Whole-lesion mean, kurtosis, and skewness of ADC were calculated and compared with T stage and pelvic nodal status at cystectomy and with subsequent metastasis in 20/25 patients with available follow-up. RESULTS: At cystectomy, 39 % (9/23) were stage T2, 61 % (14/23) ≥T3, and 28 % (5/23) exhibited positive nodes; 35 % (7/20) developed later metastases. Mean ADC was significantly lower in stage ≥T3 than in lower stage tumors (1.20 ± 0.36 × 10(-3) vs. 1.55 ± 0.36 × 10(-3) mm(2)/s; p = 0.044), but showed no association with nodal or metastatic disease (p = 0.362-0.709). Kurtosis was significantly lower in tumors with, compared to without, nodal disease (-0.05 ± 0.29 vs. 0.91 ± 1.16; p = 0.037), and showed a non-significant decrease in tumors with, compared to without, later metastases (0.23 ± 0.63 vs. 0.83 ± 0.89; p = 0.088). Kurtosis was not associated with T stage (p = 0.811), and skew was not associated with any outcome (p = 0.516-0.643). Mean ADC achieved highest AUC for identification of stage ≥T3 (AUC = 0.754 vs. 0.516-0.643 for other metrics). Kurtosis achieved highest AUC for nodal disease (AUC = 0.811 vs. 0.522-0.556 for other metrics) and metastases (AUC = 0.736 vs. 0.516-0.626 for other metrics). Only difference in AUC between skewness and kurtosis for nodal disease was significant (p = 0.031). CONCLUSION: While requiring larger studies, kurtosis has potential to complement mean ADC in bladder cancer prognosis using whole-lesion histogram analysis.	bladder
The promise of antimicrobial peptides for treatment of human schistosomiasis.	Schistosomiasis sometimes referred to as bilharzia ranks high among the common neglected human tropical diseases. Parasitic trematode flatworm belonging to the genus Schistosoma is responsible for this acute and chronic disease. Its prevalence is rapidly increasing in the tropical regions worldwide; however, its economic and global health impact is grossly underestimated. There are five recognized species of schistosome parasitizing humans but the common species causing the disease are S. haematobium, S. japonicum and S. mansoni. Over the years, praziquantel, due to its advantage over other drugs employed in the treatment of schistosomiasis especially because of its effectiveness against all schistosoma species has remained the drug of choice. Unfortunately, due to drug pressure, some reports of praziquantel resistance in the treatment of some strains of S. haematobium and S. mansoni have been documented in literature. This has necessitated the search for novel anti-schistosomal agents as alternatives to praziquantel treatment. Currently, antimicrobial peptides are gaining prominence as possible sources of novel drugs in the control and treatment of schistosomiasis. A major driving force for evaluating antimicrobial peptides is their general diverse therapeutic applications, basically due to their size and properties as well as their broad spectrum of activities. Therefore, antimicrobial peptides are attractive candidates with promising results that may overcome drug resistance problems in search for novel therapeutic agents for the control and treatment of schistosomiasis.	bladder